Impact of the COVID-19 pandemic on the services provided by the Peruvian health system: an analysis of people with chronic diseases

During the pandemic, many individuals with chronic or infectious diseases other than COVID-19 were unable to receive the care they needed due to the high demand for respiratory care. Our study aims to assess the impact of the COVID-19 pandemic on services provided to people with chronic diseases in Peru from 2016 to 2022. We performed a secondary database analysis of data registered by the comprehensive health insurance (SIS), the intangible solidarity health fund (FISSAL), and private healthcare institutions (EPS), using interrupted time series analysis. Our study identified 21,281,128 individual users who received care. The pooled analysis revealed an average decrease of 1,782,446 in the number of users receiving care in the first month of the pandemic compared with the expected values for that month based on pre-pandemic measurements. In addition, during the pandemic months, there was an average increase of 57,911 in the number of new additional single users who received care per month compared with the previous month. According to the time-series analysis of users receiving care per month based on each chronic disease group, the most significant decreases included people with diabetes without complications and chronic lung disease.新冠疫情大流行期间，受呼吸道诊疗需求大幅攀升影响，众多非新冠病毒感染的慢性疾病或传染病患者无法获得所需医疗服务。本研究旨在评估2016至2022年间，新冠疫情大流行对秘鲁慢性疾病患者所获医疗服务的影响。本研究采用间断时间序列分析方法，对综合健康保险（SIS）、无形团结健康基金（FISSAL）以及私立医疗保健机构（EPS）登记的数据集开展二次分析。研究共纳入21,281,128名接受医疗服务的个体用户。合并分析结果显示，相较大流行前基线测算的当月预期服务人数，疫情暴发首月的就诊用户数平均减少1,782,446人。此外，疫情期间各月份中，单月新增就诊个体用户数较上月平均增加57,911人。基于各慢性疾病亚组的月度就诊用户数开展时间序列分析后发现，降幅最为显著的人群为无并发症糖尿病患者与慢性肺部疾病患者。